Get access

Prepartum Work, Job Characteristics, and Risk of Cesarean Delivery


Address correspondence to: Sara B. Fein PhD, Room 2C-103, HFS-727, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740-3835.


Background: Reducing the rate of cesarean deliveries in the United States is a high priority among public health officials and members of the medical community. Many factors known to contribute to an individual woman's risk of having a cesarean rather than a vaginal delivery are not readily altered by public policy intervention. In this study we explored the effects on type of delivery of prepartum work practices, a category of factors that has a potential to affect the likelihood of cesarean delivery and to be amenable to change. Methods: Data are from U.S. Food and Drug Administration's Infant Feeding Practices Study, using questions on mail surveys administered prenatally and at 1 month postpartum. The sample comprised 1194 women who worked during pregnancy. The outcome measure is type of delivery. Predictor variables are characteristics of prepartum work: how far into their pregnancy the women work, number of hours worked, and occupation. Results: For most women, maintaining employment through the third trimester, working long hours, and working in certain occupations are not independently associated with the odds of having a cesarean delivery. However, we found marginally significant evidence that those women who worked more than 40 hours a week in a sales job were more likely to have cesarean deliveries than women who worked in other occupations. Conversely, women working part-time in sales jobs were less likely to have a cesarean delivery. Conclusion: This study provides evidence that prenatal work does not substantially increase the probability of having a cesarean delivery in most occupational categories. (BIRTH 29:1 March 2002)